Costco stores in Canada provided free samples of a frozen berry blend product that was later linked to a Hepatitis A outbreak, according to the Public Health Agency of Canada. The agency said previously that 13 people had been sickened, but adjusted the case count yesterday to 11. Four people have been hospitalized.

A recall has been issued for Nature’s Touch Organic Berry Cherry Blend sold at Costco stores inOntario, Quebec, New Brunswick, Nova Scotia, and Newfoundlandand Labrador. Consumers who have purchased this product should not consume it.

Hepatitis A is a highly contagious virus. It is transmitted Hepatitis when contaminated food or water is eaten or through contact with an infected person’s stool.

Sometimes, people infected with the virus show no symptoms. Those who do experience mild fever, loss of appetite, nausea, vomiting, diarrhea, fatigue, dark urine, clay colored stools and jaundice. Symptoms usually appear two weeks after exposure and can last for months.

Vaccination can prevent the onset of symptoms if given within two weeks of exposure. Anyone who was exposed to the recalled product, or who has symptoms consistent for Hepatitis A, should see a health care provider immediately.

The 11 cases have been reported from three provinces: Ontario (8), Quebec (2), and Newfoundland andLabrador (1). Those sickened reported onset of illness from February 2016 to March 2016.

During interviews with health officials, some of those sickened, who range in age form 16 to 70, reported eating the recalled product before developing symptoms. Eight of the case patients are male, three are female.

Consumers who have purchased the recalled product should photograph the bag and then dispose of it by placing it in plastic bag. Wash hands and anything the bag has touched with warm soapy water. Freezing does not kill Hepatitis A.

This is not the first time a Hepatitis A outbreak has been linked to frozen berries. In 2013, Townsend Farms Organic Antioxidant Blend frozen mixed berries sold at Costco stores sickened 162 people in 10 states.